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Activists focused on safe abortion and HIV/AIDS commit to working together to advance access to safe abortion everywhere and to end the AIDS epidemic as a public health threat.


  • We see the linkage between activism for HIV/AIDS and safe abortion as a critical piece of broader efforts to build a world in which every girl and woman can decide what to do with her body, her life and her future, free from discrimination, coercion and violence.
     
  • We come from many different countries and diverse backgrounds.
     
  • We are guided by a feminist agenda and the principles of bodily autonomy and equity, celebration of diversity, respect for human rights and the vision of health for all.

Together, we will:

Break down silos to increase access to quality care:
We will work together to ensure that all girls and women have access to the essential medicines and commodities they need; health workers have the knowledge and skills to provide confidential, non-judgmental and evidence-based abortion and HIV/AIDS services; and countries implement globally agreed norms and standards for abortion and HIV/AIDS care.[i],[ii],[iii]

Raise our voices to demand a world free of stigma, discrimination, criminalization, coercion and violence:
Access to HIV/AIDS and safe abortion services are greatly compromised by stigma associated with the services themselves, as well as with sexual, gender or social identities, such as being young, LGBTQ, a sex worker, a person who injects drugs or a migrant, among others.[iv] This stigma has profound impact, severely limiting access to needed services – sometimes with fatal consequences. We will advocate for the elimination of legal, economic, institutional and social barriers, as well as harmful patriarchal norms, that impede access to a full range of health services – including safe abortion – for girls and women.

Stand united against political and ideological attacks against girls’ and women’s health and rights:
Conservative agendas in many parts of the world threaten sexual and reproductive health services. The reinstatement and dramatic expansion of the Global Gag Rule by the United States government, for example, has forced non-governmental organizations to choose between providing information, counseling, referrals and access to abortion services – as well as advocating for laws and policies that promote access to safe abortion – or risk losing U.S. funding.[v] We believe our efforts are stronger together and will not allow dangerous policies and laws to divide us.

Advocate for increased, efficient and transparent funding for HIV/AIDS and comprehensive sexual and reproductive health services:
Too often, resources are siloed and do not reflect the holistic needs of girls and women.[vi] We will advocate for governments, multilateral organizations and private funders to allocate and spend resources to meet the comprehensive needs of the whole person, particularly girls and women.

Demand accountability from governments to:

  • Decriminalize all abortion-related care, HIV non-disclosure, exposure and transmission;
  • Ensure that all girls and women everywhere can live in safety and free of stigma, discrimination, coercion, violence and other legal, policy and social barriers that limit them from making their own decisions about their bodies;
  • Provide access to the full spectrum of sexual and reproductive health services, including contraceptives, safe abortion, and HIV prevention and treatment, as well as services for other sexually transmitted infections;
  • Ensure access to comprehensive sexuality education programs in and out of school;
  • Provide gender-sensitive and youth-friendly services for all, with increased effort toward integrating services and addressing service barriers faced by the most marginalized communities; and
  • Champion the rights of all girls and women to have the information and skills to decide for themselves whether and when to continue with a pregnancy and to access HIV testing, prevention and treatment services.
     

We make these commitments because we know that:

Denial of safe abortion is an act of violence against girls and women and a violation of their human rights.
Around the world, women are regularly denied access to safe and legal abortion, even though abortion can be a necessary part of how women and couples manage their fertility and their lives.[vii] The risk or fear of denial of services can be higher for girls and women living with HIV. Due to misperceptions and stigma related to HIV and AIDS, many women living with HIV have experienced additional abuses of their sexual and reproductive rights, including, but not limited to, coerced and forced sterilization.[viii]

These abuses and denial of safe abortion services are a form of gender-based violence and constitute a serious violation of girls’ and women’s rights to life; freedom from torture and cruel, inhumane or degrading treatment or punishment; liberty and security; non-discrimination; and equality.[ix]

Criminalizing abortion, HIV non-disclosure, exposure and transmission harms everyone.
When laws and policies infringe upon the right to autonomy, people are denied the ability to make informed choices regarding their bodies. Criminalizing abortion does not prevent it from happening, but instead forces women to seek clandestine, and sometimes unsafe, procedures. Unsafe abortions occur overwhelmingly in countries that highly restrict abortion, with the greatest burden on marginalized communities.[x]

These same communities are also often at the greatest risk for HIV and for the denial of health services due to the criminalization of their identities or behaviors. Criminalization of HIV non-disclosure, exposure and transmission fuels fear and stigma and can prevent people from accessing life-saving testing, prevention and treatment services.[xi] Criminalization and denial of services has long-lasting consequences for families and communities throughout the world.[xii]

AIDS and unsafe abortions are killing girls and women, particularly in developing countries.
Almost half of all abortions worldwide are unsafe due to restrictive laws and policies and limited access to trained providers, with the vast majority occurring in developing countries.[xiii] Unsafe abortions account for between 8% and 11% of maternal deaths globally.[xiv] Similarly, among new HIV infections, about 64% are in sub-Saharan Africa.[xv]

Girls and young women are disproportionately impacted. In 2016, new HIV infections among young women (15-24) were 44% higher than they were among young men.[xvi] Globally, AIDS-related illnesses remain the leading cause of death among women of reproductive age (15-49).[xvii] Pregnancy complications, including from hemorrhage, sepsis, obstructed labor, and unsafe abortion are the leading cause of death among adolescent girls aged 15-19 years.[xviii]
 

 
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References

[i]. World Health Organization (2012). Safe abortion: technical and policy guidance for health systems. Second edition.
[ii]. World Health Organization (2016). Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. Second edition.
[iii]. World Health Organization (2017). Consolidated guideline on sexual and reproductive health and rights of women living with HIV.
[iv]. Fried S (2016). Women’s bodily integrity: linking criminalisation of abortion and criminalisation of HIV. The Lancet Global Health Blog.
[v]. CHANGE (2018). Impact of Expanded Global Gag Rule on Women’s Health.
[vi]. Manski R, Dennis A, Blanchard K, Lince N, and Grossman D (2012). Bolstering the Evidence Base for Integrating Abortion and HIV Care: A Literature Review. AIDS Research and Treatment.
[vii]. Singh S, Remez L, Sedgh G, Kwok L, and Onda T (2017). Abortion Worldwide 2017: Uneven Progress and Unequal Access. Guttmacher Institute.
[viii]. Rowlands S and Jean-Jacques A (2018). Non-consensual sterilization of women living with HIV. International Journal of STD and AIDS.
[ix]. Committee on Economic, Social and Cultural Rights general comment No. 22 (2016), para 10 and Committee on the Elimination of Discrimination Against Women general recommendation No. 35 (2017), para 15.
[x]. Op. cit. 7.
[xi]. Burris S and Cameron E (2008). The Case Against Criminalization of HIV Transmission. JAMA.
[xii]. Amnesty International (2018). Body Politics: A Primer on Criminalization of Sexuality and Reproduction.https://www.amnesty.org/download/Documents/POL4077632018ENGLISH.PDF
[xiii]. Guttmacher Institute (2017). Worldwide, an Estimated 25 Million Unsafe Abortions Occur Each Year. https://www.guttmacher.org/news-release/2017/worldwide-estimated-25-million-unsafe-abortions-occur-each-year
[xiv]. Op. cit. 7.
[xv]. UNAIDS Data (2017). Joint United Nations Programme on HIV/AIDS (UNAIDS). http://www.unaids.org/sites/default/files/media_asset/2017_data-book_en.pdf
[xvi]. Ibid.
[xvii]. Ibid.
[xviii]. World Health Organization (2017). Global health estimates 2016: deaths by cause, age, sex, by country and by region, 2000-2016.